Lack of awareness of benefits of preventative vet care, benefits(as well as risks especially for elderly or very young kittens) of vaccines, benefits of screening and catching problems early when they might be easily helped with diet changes or medications. I am sure these issues are affected by expense concerns as well, but increased knowledge might help.
There was a time when people went to doctor and just did what they were told, now quality medical care encourages engagement and questions. More engagement with the vet (asking about risks, benefits, potential outcomes and any other existing medical issues would help.
To put this in context, I have adopted and fostered many senior/geriatric dogs and cats, and as difficult as it might be, the above questions help me determine the best care and quality of life for these animals. I also expect full informed involvement in my own medical care.
#AccesstoCare